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Ask the Mental Health Expert Archives 2001-2004

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Long Term Effects of Abuse

Q. What are the long term effects of verbal and physical abuse on children? In adulthood would they have drug abuse problems, depression and violent behavior? I am also curious to know why some people remain victims their entire lives, while others with less favorable beginnings go on to solid, successful lives. Are there specific steps one can take to cope instead of becoming a victim?

A. Physical, sexual, and verbal abuse certainly do take their toll on children as they emerge into adulthood--but, as your question suggests, much depends on the individual's coping skills and support system, in the wake of such victimization. In one study by Rossow & Lauritzen (Addiction 2001 Feb;96(2):227-40) self-reported suicidal behavior and ideation among drug addicts was higher among those who reported various adverse experiences during childhood (e.g., sexual or violent assaults, bullying, or parents' alcohol abuse).

In another study (Heffernan et al, Addict Behav 2000 Sep-Oct;25(5):797-803), opiate users were 2.7 times more likely to have a history of childhood sexual and/or physical abuse than nonopiate users, after controlling for diagnostic and sociodemographic variables. Opiate use was higher among those reporting physical abuse alone (24.1%) or both physical and sexual abuse (27%) than among those reporting sexual abuse alone (8.8%). Another study by Higgins & McCabe (Child Maltreat 2000 Aug;5(3):261-72) found an association between five different types of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect, witnessing family violence) and poor adjustment in adulthood (trauma symptomatology and self-depreciation). And yet, not every child who is abused or traumatized grows up to be a disturbed or dysfunctional adult.

According to the research of Dr. Naomi Breslau and colleagues, published in the March 1991 Archives of General Psychiatry, more than 75% of individuals exposed to typical traumatic events did not develop PTSD--though the rate of PTSD was 80% in women who reported rape. Breslau's group found that the risk of developing PTSD after severe trauma is increased by several factors: early separation from parents, neurotic traits, pre-existing anxiety or depression, and a family history of anxiety. So the risk of PTSD springing up is probably much greater when a traumatic event falls on fertile soil.

Psychologist Martin Seligman has spent years researching the differences between kids who become depressed, and kids who thrive. The critical difference seems to lie in their diverging views of themselves and their world--whether they see themselves as eternally helpless, hopeless shlemiels, or as capable and competent winners. For more information on PTSD and its risk factors, I recommend the book "Psychological Trauma", edited by Rachel Yehuda, American Psychiatric Press, 1998. As to how traumatized individuals can learn to cope and overcome their traumas, I recommend the book, "Coping With Trauma", by Dr. Jon Allen. Becoming socially and creatively engaged in life is certainly a big part of overcoming the effects of trauma.

August 2001

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